In a time not that long ago, if a child announced that he or she wanted to be a nurse or doctor, their parents would be overjoyed to tell their friends. They may have even been relieved that their offspring picked one of the service professions without overt physical risk as often seen in firefighters and law enforcement. But in current culture, that may no longer be the case. Turns out, health care is a dangerous profession – actually, the most dangerous profession. Health care workers suffer more workplace injuries than any other profession, with about 654,000 harmed per year on the job. The most common types of harm suffered in the hospital setting include back injury, needle sticks, blood and body fluid exposures and smoke inhalation. These workplace hazards often go under the radar. Many physicians, nurses and others simply do not recognize the risks or, worse yet, consider it part of the job. So driven by mission, they put patients' needs before anything else. Take, for example, lifting and moving patients. This occurs for nursing at a high rate – at least once an hour. In school, lifting and transferring patients are taught as routine skills. And while there is some equipment to assist in lifting, it's often not utilized since it can be cumbersome and is perceived to slow down helping the patient and impacting efficiency. As such, aching back and feet are often seen as badges of courage rather than signs of workplace injury. In addition, there are about 385,000 needle sticks per year. Despite education and technology, the risk remains relatively unchanged. The price of an unintended stick? Lots of blood draws, and maybe even HIV prophylaxis with up to three drugs. Certainly not a deal. In addition to the injuries that "are part of the job," there's been an increase in workplace violence in hospitals. In fact, 45 percent of all workplace violence incidents occur in the health care setting. It's actually not terribly surprising: The environment is the perfect recipe for violence. Patients feel poorly, are frightened and often face great uncertainty regarding their future. For family members, the stress can lead to disruptive and explosive behavior. This seems to be particularly true in pediatric hospital settings where parents tend to be young, resource-limited in both the monetary and support system realms, and pushed to their intellectual and emotional limit trying to navigate the hospital journey for their extremely vulnerable child. Across the entire spectrum of medicine, somewhere between 40 and 75 percent of health care workers report having suffered physical or verbal abuse from a patient or their family. In fact, most such episodes are prolonged for hours to days, with many figuring that putting up with such behavior is "part of the job." In addition to going home with aching feet, they may be bruised, either bodily or metaphysically. The toll is tremendous on the health care worker, his or her colleagues and families, and society as a whole. The work force shortage predicted in health care is massive and in part due to the dangers of the environment and its effect on the health of those sworn to provide care and comfort to all who come. And in a system that has moved toward the patient as customer with focus on their satisfaction, there is little in the way of protection afforded to those dedicated to providing health care, unless it comes at the local level. Government has not put sanctions or disincentives in place for those who act out in hospitals, and it doesn't seem to be on the immediate horizon. In that case, it is incumbent on the ones who work in health care to try and mitigate this workplace harm, much like we've worked on patient safety. Emphasis needs to be placed on technique regarding lifting and needle disposal. Proper equipment needs to be available and its use encouraged, even if efficiency might be slightly impacted. De-escalation techniques need to be taught in regard to diffusing violence in the workplace. The emotional toll of illness on patients and their families often results in atypical behavior of people, but with the right approach, these situations can often be headed off at the pass. In addition, making sure that escape routes – like having line of sight to the door – need to be repeated in huddles and rounds routinely to maintain awareness. However, such techniques are not embedded in the curriculum of most professional schools. The health care professions have always been chock full of intangible rewards that naturally come from serving others. This comes from putting the patient at the center of all health care activities and decisions. We as a collective have spent much needed time and energy on defining the value proposition for our patients. That continues to be great work, but statistics tell us we need to think about the value proposition for our providers. It is a must if we want to continue to recruit the best and brightest to the field. The time will come when all of us need both the expertise and compassion of those medical teams, and it would be nice if they weren't wearing body armor at our bedside. Source
